Fulminant Cardiac Sarcoidosis Successfully Treated With Aggressive Immunosuppressive Therapy

Yasumura, Kaori; Sera, Fusako; Akazawa, Yasuhiro; Nakamoto, Kei; Kawai, Makiko; Kurashige, Masako; Nakamura, Daisuke; Oka, Takafumi; Mizote, Isamu; Morii, Eiichi; Ohtani, Tomohito; Sakata, Yasushi

doi:https://doi.org/10.1155/cric/1350557

Fulminant Cardiac Sarcoidosis Successfully Treated With Aggressive Immunosuppressive Therapy

Yasumura, Kaori; Sera, Fusako; Akazawa, Yasuhiro et al.

Case Reports in Cardiology, 2025, 2025(1), 1350557

Number of Access:79（2025-06-18 14:34 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/101403

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Title	Fulminant Cardiac Sarcoidosis Successfully Treated With Aggressive Immunosuppressive Therapy
Creator	CreatorName Yasumura, Kaori
	NRID 1000070794139 1000070794139 ORCID 0000-0002-9260-6901 0000-0002-9260-6901 researchmap permalink fsera fsera Scopus Author ID 57196563132 57196563132 CreatorName Sera, Fusako
	NRID 1000080882266 1000080882266 researchmap permalink y-akzw y-akzw Scopus Author ID 36096360000 36096360000 CreatorName Akazawa, Yasuhiro
	CreatorName Nakamoto, Kei
	CreatorName Kawai, Makiko
	NRID 1000010836422 1000010836422 researchmap permalink gerbil gerbil CreatorName Kurashige, Masako
	NRID 1000030869970 1000030869970 researchmap permalink daifromn0525 daifromn0525 CreatorName Nakamura, Daisuke
	NRID 1000030647285 1000030647285 researchmap permalink Takafumioka0410 Takafumioka0410 Scopus Author ID 8712739400 8712739400 CreatorName Oka, Takafumi
	NRID 1000010584609 1000010584609 researchmap permalink mizoteisamu mizoteisamu Scopus Author ID 8266113500 8266113500 CreatorName Mizote, Isamu
	NRID 1000010283772 1000010283772 ORCID 0000-0001-8490-3650 0000-0001-8490-3650 researchmap permalink read0046454 read0046454 Scopus Author ID 7003914326 7003914326 CreatorName Morii, Eiichi
	NRID 1000030623897 1000030623897 researchmap permalink tohtani tohtani Scopus Author ID 57932819800 57932819800 CreatorName Ohtani, Tomohito
	NRID 1000000397671 1000000397671 ORCID 0000-0002-5618-4721 0000-0002-5618-4721 researchmap permalink C4589 C4589 Scopus Author ID 35395964700 35395964700 CreatorName Sakata, Yasushi
Description	Yasumura Kaori, Sera Fusako, Akazawa Yasuhiro, et al. Fulminant Cardiac Sarcoidosis Successfully Treated With Aggressive Immunosuppressive Therapy. Case Reports in Cardiology 2025, 1350557 (2025); https://doi.org/10.1155/cric/1350557.
Abstract	Background: The clinical course of cardiac sarcoidosis is typically subacute, and fulminant cases requiring mechanical circulatory support are rare. Here, we report the case of a patient with pathologically diagnosed cardiac sarcoidosis who presented with fulminant myocarditis and whose cardiac function was improved by aggressive immunosuppressive therapy based on the treatment of giant cell myocarditis. Case Presentation: A 55-year-old woman presented with progressive dyspnoea and nausea that persisted for 1 month and was eventually diagnosed with acute heart failure. Echocardiography showed a reduced left ventricular ejection fraction with thinning of the basal septal wall. During hospitalisation, she experienced ventricular tachycardia and fibrillation attacks, and bradycardia due to a complete atrioventricular block and sinus dysfunction was observed after starting amiodarone. Subsequently, she underwent intra-aortic balloon pump insertion in addition to inotropic agent administration; however, venoarterial extracorporeal membrane oxygenation and Impella 5.0 were needed because biventricular dysfunction progressed. We diagnosed our patient with cardiac sarcoidosis based on the pathological findings revealing inflammatory cell infiltration, including giant cells with extensive fibrosis and granulomas. However, the possibility of giant cell myocarditis could not be ruled out because of the fulminant clinical course; therefore, aggressive immunosuppressive therapy with corticosteroids and cyclosporine was started. Her cardiac function improved, and all mechanical circulatory support and inotropic agents were discontinued. Conclusion: Cardiac sarcoidosis is difficult to differentiate from giant cell myocarditis because they have many similarities in terms of myocardial histopathology and clinical manifestations. While whether the two diagnoses are parts of a single-disease continuum remains debatable, aggressive combination immunosuppressive therapy may contribute to favourable outcomes.
Publisher	Wiley
Source Title	Case Reports in Cardiology
Volume (Issue)	2025(1)
Page	1350557
Date of Issued	2025-03-11
Language	English
Handle URL	https://hdl.handle.net/11094/101403
PISSN	20906404
eISSN	20906412
Relation.isIdenticalTo	DOI (Publisher Version) https://doi.org/10.1155/cric/1350557
Access Rights	open access
CopyRight	This article is licensed under a Creative Commons Attribution 4.0 International License.
oaire:version	Version of Record
Category	学術雑誌論文 Journal Article

Resource Type	journal article
Local Type	Journal Article
DCMI Type	Text
DCTERMS.bibliographicCitation	Case Reports in Cardiology. 2025, 2025(1), p. 1350557
DC.title	Fulminant Cardiac Sarcoidosis Successfully Treated With Aggressive Immunosuppressive Therapy
DC.creator	Yasumura, Kaori
	Sera, Fusako
	Akazawa, Yasuhiro
	Nakamoto, Kei
	Kawai, Makiko
	Kurashige, Masako
	Nakamura, Daisuke
	Oka, Takafumi
	Mizote, Isamu
	Morii, Eiichi
	Ohtani, Tomohito
	Sakata, Yasushi
DC.publisher	Wiley
DC.language' scheme='DCTERMS.RFC1766	English
DC.type' scheme='DCTERMS.DCMIType	Text
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2025-03-11
DC.identifier	https://doi.org/10.1155/cric/1350557
DC.description	Yasumura Kaori, Sera Fusako, Akazawa Yasuhiro, et al. Fulminant Cardiac Sarcoidosis Successfully Treated With Aggressive Immunosuppressive Therapy. Case Reports in Cardiology 2025, 1350557 (2025); https://doi.org/10.1155/cric/1350557.
DCTERMS.abstract	Background: The clinical course of cardiac sarcoidosis is typically subacute, and fulminant cases requiring mechanical circulatory support are rare. Here, we report the case of a patient with pathologically diagnosed cardiac sarcoidosis who presented with fulminant myocarditis and whose cardiac function was improved by aggressive immunosuppressive therapy based on the treatment of giant cell myocarditis. Case Presentation: A 55-year-old woman presented with progressive dyspnoea and nausea that persisted for 1 month and was eventually diagnosed with acute heart failure. Echocardiography showed a reduced left ventricular ejection fraction with thinning of the basal septal wall. During hospitalisation, she experienced ventricular tachycardia and fibrillation attacks, and bradycardia due to a complete atrioventricular block and sinus dysfunction was observed after starting amiodarone. Subsequently, she underwent intra-aortic balloon pump insertion in addition to inotropic agent administration; however, venoarterial extracorporeal membrane oxygenation and Impella 5.0 were needed because biventricular dysfunction progressed. We diagnosed our patient with cardiac sarcoidosis based on the pathological findings revealing inflammatory cell infiltration, including giant cells with extensive fibrosis and granulomas. However, the possibility of giant cell myocarditis could not be ruled out because of the fulminant clinical course; therefore, aggressive immunosuppressive therapy with corticosteroids and cyclosporine was started. Her cardiac function improved, and all mechanical circulatory support and inotropic agents were discontinued. Conclusion: Cardiac sarcoidosis is difficult to differentiate from giant cell myocarditis because they have many similarities in terms of myocardial histopathology and clinical manifestations. While whether the two diagnoses are parts of a single-disease continuum remains debatable, aggressive combination immunosuppressive therapy may contribute to favourable outcomes.
DC.rights	This article is licensed under a Creative Commons Attribution 4.0 International License.
DC.format	101403
citation_title	Fulminant Cardiac Sarcoidosis Successfully Treated With Aggressive Immunosuppressive Therapy
citation_author	Yasumura, Kaori
	Sera, Fusako
	Akazawa, Yasuhiro
	Nakamoto, Kei
	Kawai, Makiko
	Kurashige, Masako
	Nakamura, Daisuke
	Oka, Takafumi
	Mizote, Isamu
	Morii, Eiichi
	Ohtani, Tomohito
	Sakata, Yasushi
citation_publisher	Wiley
citation_language	English
citation_date	2025-03-11
citation_journal_title	Case Reports in Cardiology
citation_volume	2025
citation_issue	1
citation_firstpage	1350557
citation_doi	https://doi.org/10.1155/cric/1350557
citation_public_url	https://hdl.handle.net/11094/101403

Fulminant Cardiac Sarcoidosis Successfully Treated With Aggressive Immunosuppressive Therapy

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